Participating in the Contouring Accuracy Program

IN THIS ARTICLE

By participating in the contouring accuracy program, you can hone you contouring skills, earn points toward digital badges with the ProKnow achievement system, and earn continuing education credits through the MDCB and AAMD. Read on to learn how to participate.

The Contouring Accuracy Dashboard

When you sign up for a ProKnow account and purchase a Contouring Accuracy Subscription, your Contouring Accuracy Dashboard will look something like this:

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  1. Select Organization: Use this dropdown menu to switch to the contouring instances for another organization. In this list, you will only see public organizations or organizations to which you belong.
  2. Your ProKnow Wallet: Once you become a member, your ProKnow wallet will be display in the left sidebar. This panel tells you (1) what kind of subscriber you are (monthly or annual), (2) when your next token(s) will be allotted, and (3) how many structure tokens you have available to spend on premium structures.
  3. Categories: Use the categories menu to show and hide structures by their categories (e.g., Gastrointestinal, Head & Neck, etc.).
  4. Filter By Instance Type: Use this dropdown menu to select a subset of structure instances to display. The options are All Structures, My Library, Available Now, and Coming Soon.
  5. Filter By Instance Name: Use this input field to filter structure instances by their name. For instance, filtering by "left" would show only the structures Left Brachial Plexus (2016-08), Left Parotid (2016-10), and Left Submandibular Gland (2016-11).
  6. Group By Structure: Check this box to group structure instances by structure. For instance, the left and right parotid instances would be grouped under the structure Parotid and the optic chiasm instance (one on CT and one on MR) would be grouped under the structure Optic Chiasm.
  7. Members-Only Structures: Members-only structures are only accessible to contouring accuracy subscribers and are marked with a blue "M".
  8. Free Structures: Free structures are accessible to all ProKnow users - with or without a subscription. These structure are marked with a blue "F".
  9. Premium Structures: Premium structures must be redeemed using a structure token. Once redeemed, they're yours to keep forever. These structure are marked with a green "P".

Contouring Instances Overview

Completing a contouring instance follows with the familiar Plan-Do-Study-Act cycle.

  1. Plan: On the Instructions tab, read the instructions and review the provided educational material.
  2. Do: Go to the Contour and Score tab, launch the contouring tools, and contour the structure. Then generate your score.
  3. Study: Once you contours have been scored, study the difference between your contours and the expert's, and review any accompanying learning material on the Learn tab.
  4. Act: Go to the Redo and Practice tab to put what you have learned into action. Relaunch the contouring tools and adjust your contours and rescore.

In addition, check out the CE Credits tab to learn more about earning CE credits for premium structures and visit the Population Results tab to view population statistics and population consensus contours. For more information on setting up your account to earn CE credits, visit Earning CE Credits with the Contouring Accuracy Program.

Using the Contouring Tools

When you launch the contouring tools, you will be presented with a screen that looks something like this:

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  1. Structure Name: The name of the structure is a useful reminder for what you are currently contouring.
  2. Toolbar: Tools for slice navigation, adjusting window and level settings, zooming, panning, drawing, painting, and more. For more details, see below.
  3. Axial View: The axial slices are rendered here.
  4. Sagittal View: The sagittal reconstruction of the image set.
  5. Coronal View: The coronal reconstruction of the image set.
  6. "I'm Finished" Button: Use this button to save and exit the contouring tools.

Slice Navigation

To navigate through the slices in slice navigation mode, simply point-and-click or drag the crosshairs to the desired slice position.

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Pro tip: Use the arrow keys and your mouse's scroll wheel to navigate through the slices. This will work even when you have another tool selected.

Window/Level

To adjust the window/level settings in window/level mode, adjust the vales using the input fields or sliders or drag your cursor up and down to adjust the window and left and right to adjust the level.

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You can also invert the pixel values by checking Invert Pixels.

Zoom

With the zoom tool selected, zoom in by clicking and dragging your cursor to the top right corner. Zoom out by clicking and dragging your cursor to the bottom left corner.

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Pro tip: To zoom in and out while working with a different tool, hold down the Ctrl key and scroll the mouse wheel up and down.

Pan

To pan the image set in pan mode, click and drag to position the image set.

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Pro tip: To pan the image set while working with a different tool, hold down the Ctrl key and click and drag to position the image set.

Draw

In draw mode, you can draw a contour in a point-and-click fashion or you click and drag to draw a continuous line.

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Pro tip: Hold down the Alt key to toggle the drawing mode ( add versus subtract). This can be useful for drawing bifurcated structures or structures with holes.

Paint

In paint mode, you can paint a contour by clicking and dragging the paintbrush across the image. Adjust your brush size using the input field or slider control.

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Pro tip: Hold down the Alt key to toggle the paint mode ( add versus subtract). This can be useful for drawing bifurcated structures or structures with holes.

Interpolation and Copying

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  1. Interpolate All: Use this button to interpolate your contours over empty or skipped slices. Once clicked, ProKnow DS will attempt to generate contours on all empty slices between slices containing contours. There are several situations in which warnings will be reported after the interpolation has completed. Please note that when these warnings are displayed, only the indicated range will have not been interpolated. Any other empty slices able to be interpolated will be completed. The most common warnings include:
    • Unable to interpolate between the slice at X.XX mm and the slice at Y.YY mm as the slices each contain multiple contours and the contour orientations are not consistent (most commonly caused by complex bifurcation scenarios). This is an uncommon case that can occur when attempting to interpolate between slices that have the same number of contours, but the orientations of the contours are not consistent from one slice to the other. For example, in the following images, you can see two slices, Slice A, which contains two contours: a circle and a hole; and Slice B, which also contains two contours: two circles. Please note that in both of these images, the "interior" portion of the contours have been slightly filled to aid in the visual distinction.
      cap-10.png
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      In this case, the contour orientations between the two slices (1 CCW and 1 CW in Slice A and 2 CCW in Slice B) do not match, and indeed, there is no obvious solution for how to interpolate between these two slices.
    • Unable to interpolate between the slice at X.XX mm and the slice at Y.YY mm as no valid combination of overlapping contours could be found. This situation can occur when interpolating between slices that contain different numbers of contours. When there is a different number of contours from one slice to another, for example, between Slice A and Slice B below, ProKnow attempts to determine the most suitable pairwise combination of contours by looking at the overlapping area between all contours from one slice to another. ProKnow interpolates, in order of greatest overlapping area, from each contour on the first slice to the corresponding contour on the second slice. For example, when interpolating between Slice A and Slice B, ProKnow will interpolate the larger circle from Slice A to the single circle on Slice B since, if superimposed onto the same slice, their areas would overlap.
      cap-12.png
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      However, when interpolating from Slice B to Slice C, the circles share no area in common and thus, ProKnow DS will report a warning when attempting to interpolate between these two slices.
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      In general, it is always best to interpolate between highly similar slices, especially in cases where there are multiple contours present on each slice.
  2. Copy from Previous: Use this button to copy contours from the previous slice.
  3. Copy from Next: Use this button to copy contours from the next slice.

Import

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If you would like to contour in your own contouring software instead of ProKnow, you may download the images (See How do I use zipped files? for more information) using the Download Images button (1). After you complete your contours, export the structure set from your software and load it into ProKnow (2). Note that this feature is disabled for certain image sets.

Options

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  1. Clear Slice: Use this button to clear the current slice of all contours.
  2. Clear All Slices: Use this button to clear all slices of all contours.
  3. Toggle Contour Visibility: Uncheck Show Contours to turn off the contour lines. Note that editing your contours is disabled while contours are turned off.
  4. Keyboard Shortcuts: Use this button to view keyboard shortcuts.
Pro tip: Press the V key to toggle contour visibility.

Tutorial Video

Using any new software can be challenging, so we've put together this tutorial video that offers an overview of the contouring tools available in ProKnow's Contouring Accuracy Program. If you want to see a feature we don't have, let us know by clicking the Contact button on our support page. We'd love you hear from you!

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